In July 2013, the US Food and Drug Administration approved the use of NEBA as the first device for the complementary evaluation of attention deficit hyperactivity disorder (ADHD). It is based on quantitative electroencephalogram (qEEG) and includes the standardised theta/beta ratio, the results of which were consistent with both the medical and psychological clinical evaluation. Likewise, it has proved to be a useful tool for determining whether the ADHD is primary, secondary or comorbid to another pathology. Yet, to date no publications have specified whether it is a total theta/beta ratio or theta/beta-1 and theta/beta-2. Additionally, no data are provided to be able to discriminate between diagnostic subtypes of ADHD. To quantify the theta/beta ratios, by means of qEEG, in a sample of patients from the Rio de la Plata area with a main confirmed diagnosis of ADHD, in order to compare the neurophysiological patterns according to the diagnostic subtypes. We used a randomised stratified sample of 62 subjects of both sexes, with ages between 8 and 17 years, distributed into two groups, depending on the diagnostic subtype: attention deficit subtype of ADHD (n = 31) and the combined subtype of ADHD (n = 31). High theta/beta-1 and theta/beta-2 ratios were confirmed in the Cz region, being higher than the ratios in the C3 and C4 areas. Moderate and statistically significant differences were found between the two subtypes only in the beta-1 band in the occipital regions. The analysis of the interhemispheric coherence suggests an association of the power peak crossed with the diagnostic subtype, which is the fastest peak (10 Hz) for the combined subtype. No important differences are found on analysing the phase spectra or the theta/beta ratios. Although the scientific literature, especially the NEBA system, highlights the importance of the theta/beta ratio in the differential diagnosis of ADHD in control samples and other neurodevelopmental disorders, a distinction must be made between beta-1 and beta-2.

Non-epileptic paroxysmal disorders during sleep are a great challenge for the clinician. It is important to know the various clinical manifestations for appropriate differential diagnosis, since alterations in sleep, mostly motor, are part of these disorders. Our paper describes the normal sleep stages and electroencephalographic characteristics and polysomnography basic data. The confusions especially with nocturnal frontal lobe epilepsy are frequent and cause unnecessary drugs administered, the emotional burden of the parents or caretakers, which is the diagnosis of epilepsy. We discuss the possible causes of diagnostic errors.

Focal cortical dysplasias (FCD) are the first cause of surgery in paediatric epilepsy surgery. The pre-surgical assessment in FCD is often complex, since they are lesions that can be highly epileptogenic and at the same time can preserve neurological functioning and may not be displayed in magnetic resonance imaging. The success of the operation largely depends on the proper identification of the lesion and the possibility of performing a complete resection of the dysplastic tissue. In this work we review the literature related with this topic, in relation to the authors' experience. The study reviews some of the advances made as regards the pre-surgical assessment and the neurosurgical management of epilepsy in children with FCD; results from the surgical series regarding the classifications of FCD and the post-surgical prognostic factors are commented on; some anatomo-clinical phenotypes that are distinctive in children with FCD and their surgical management are described; and current challenges and the future of the surgical treatment of epilepsy in FCD are also briefly discussed. The advances being made in the methods of pre-surgical diagnosis and surgical procedures are making it possible to offer successful treatment at earlier ages in patients with FCD who were previously considered 'non-lesional' and in patients with localised lesions in the 'eloquent cortex'. The identification of anatomo-electro-clinical phenotypes of FCD makes it possible to establish surgical approaches and post-surgical prognostic expectations that are well suited to each situation, which are better in the transmantle-type FCD IIb and in bottom-of-sulcus dysplasias than in multilobe FCD, which are mostly FCD I.

The cardinal symptoms of attention deficit hyperactivity disorder (ADHD)--inattention, hyperactivity and impulsiveness--are not specific and may be found in the general population and in other disorders. These symptoms are present in over 50% of patients with autism spectrum disorders (ASD). It thus seems quite clear that both problems can coexist in these patients. The usual pharmacological treatments for ADHD, methylphenidate and atomoxetine, appear to be useful in reducing the above-mentioned symptoms in patients with ADHD and ASD. Effectiveness seems to be lower in patients with ASD and tolerance is slightly poorer. This may be conditioned by a number of variables, including: the complexity of ASD, association with mental retardation, polypharmacotherapy, and so on. Given the long-term tolerance profile of methylphenidate and atomoxetine, these treatments appear to be a good alternative with which to improve the problems of attention and self-control these patients have. Nevertheless, further controlled studies are needed to confirm this proposition.

Requiem por el tetracepam.

Utilidad de los ultrasonidos en la deteccion de fasciculaciones musculares.

The objective of this work is to review the existing literature on findings from structural and functional magnetic resonance and connectivity. For a long time it was thought that children 'grew out' of attention deficit hyperactivity disorder (ADHD) on reaching adolescence. Yet, it is now known that up to 70% of children who present ADHD in childhood go on to present symptoms in the behavioural and cognitive sphere in adulthood. Neuroimaging studies conducted in adults with ADHD have shown alterations in the brain at the structural and functional levels, and also in terms of connectivity. These findings have been observed mainly in the inferior frontal and dorsolateral prefrontal cortex, as well as in striatal, anterior cingulate, parietotemporal and cerebellar regions. However, certain inconsistencies have also been found, which may be related with the presence of comorbidity, a history of medication, gender-related differences and the small size of the sample used in some studies. Differences have also been noted in relation to studies carried out in children with ADHD. Hence the importance for future studies of avoiding the existence of variables that can affect the findings in ADHD in adults and, moreover, of being able to determine whether the anatomical and functional deficits continue into adulthood.

Children with coordination disorder -non verbal learning disorder, procedural learning disorder (PLD)- have difficulties in understanding complex simultaneous visual information. Validation of two different visual tasks to measure central coherence function of children with PLD. A chimeric image and a complex visual story are showed to 200 schoolchildren: 20 of them have PLD, 60 have PLD plus attention deficit/hyperactivity disorder (PLD + ADHD), 60 have non comorbid ADHD, and 60 subjects are typical control children. A chi square test and a discriminant analysis are used to study the performances of the different groups in verbal description of both images. Performance is lower in children with PLD and PLD + ADHD than in those with non-comorbid ADHD or controls. Moreover 93% and 92% of children with poor performance in, respectively, chimeric and complex images, have PLD or PLD + ADHD. Eighty seven per cent of subjects with PLD + ADHD fail in some of the tasks and, by contrast only 15% of children with ADHD do. Children with PLD have disability in quick understanding of simultaneous complex information and central coherence. The two tasks used in this research are useful to detect these difficulties, with high sensibility and specificity.

Chronic migraine (that is to say, cases where migraine is suffered on 15 or more days per month) is an illness that affects approximately 0.5-2.5% of the population, depending on the statistics that are analysed and the definition of chronic migraine used. The incidence of transformation from episodic to chronic migraine is 3% per year, and 6% go from low-frequency (1-9 days/month) to high-frequency migraine (10-14 days/month). The risk factors for developing chronic migraine are genetic, frequent use of painkillers, being female, having poor hygienic-dietary habits, developing anxiety/depression, having a low socioeconomic status, suffering from obesity and being divorced or widowed. Despite the modification of the risk factors, it has still not been proved that the chances of developing chronic migraine can be lowered. Chronic migraine has an important impact on patients' quality of life, as measured on disability, quality of life and impact on daily activities scales. These patients have twice the chance of suffering from depression, anxiety and chronic pain, which means they therefore need greater health care. Many have still to be diagnosed and treated, however. In a Spanish epidemiological study, a follow-up was carried out on patients with chronic daily headache after undergoing a therapeutic intervention and up to 60% of the patients showed improvement. In other words, with increased interest and diagnosis of this illness, many patients would benefit from suitable treatments.